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RIC Introduces Pediatric Lokomat Therapy to Enhance Ability to Walk in Neurologically Impaired Child
The Rehabilitation Institute of Chicago is now offering the pediatric version of the Lokomat robot-assisted walking therapy.
By Robotics Trends Staff - Filed May 19, 2009

Natalie Davis, 10, works with physical therapist Mike Klonowski during a session on the Lokomat.

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The Rehabilitation Institute of Chicago (RIC) announced it’s offering Pediatric Lokomat therapy, or robot-assisted walking therapy, for children with neurological conditions such as cerebral palsy(CP), to help improve their ability to walk and achieve their life goals and dreams.

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Cerebral palsy is a neurological condition affecting the motor control portion of the brain often accompanied by secondary orthopaedic conditions affecting a child’s voluntary muscle activation, tone, reflexes, coordination, balance and ability to walk and be independent. CP is the leading cause of disability in children, and approximately 800,000 adults and children in the U.S. currently live with CP. An additional 10,000 babies born this year are estimated to develop this condition[2].

“RIC is committed to discovering new treatments that maximize the abilities of kids with cerebral palsy allowing them to achieve their goals in life,” said Deborah Gaebler-Spira, MD, director of the cerebral palsy program at RIC. “There is an immense need for research in this area, and RIC is dedicated to examining the vast opportunities and discovering new treatments that advance ability for those who are living with CP.”

About Lokomat Therapy
Robot-assisted walking therapy is a form of physical therapy that uses a robotic device to help a person improve his or her ability to walk. The patient is suspended in a harness over a treadmill, and an exoskeleton robotic frame, attached by straps to the outside of the legs, moves the legs in a natural walking pattern. A computer controls the pace of walking and measures the body’s response to the movement. The pediatric model also has an interactive gaming interface which, through cartoon characters and challenges, motivates children and provides them instruction.

Currently, this type of physical therapy is conducted with the aid of two or more therapists who manually move the patient’s legs in a walking pattern. The strenuous nature and variability of the manual method can limit the frequency and duration of therapy. In the Lokomat, the robotic device does most of the heavy work, the pattern and pace are consistent throughout the session, and the exercise can be sustained over longer periods of time, making it more effective.

The Science Behind the Treatment
RIC has been examining and tracking the effects of this therapy for adults for years and continues to focus on new research and clinical trials that provide more data on this treatment. In fact, RIC was the first hospital in the U.S. to obtain this technology and began clinical trials with the Lokomat® when it was first approved by the Food & Drug Administration in March 2002. In addition to its research studies, RIC now makes robot-assisted walking therapy available in the clinical setting for adult inpatients and outpatients as well.

In an early study conducted in Europe [3] examining the use of Lokomat therapy for children with CP, results indicated an improvement in walking speed and in gross-motor function. The therapy was also rated “excellent” in providing motivation for carrying out therapy among a majority of children, while there was also a very high level of approval from the therapy team and parents.

Natalie’s Story
Natalie Davis, 10, from Plano , Ill. , has one goal – to play soccer. Davis, who mainly uses a wheelchair to move around because of the weakness and abnormal coordination in her legs, has experienced ongoing treatment and therapy to manage the effects of CP her whole life.  She has had regular physical therapy, botox treatments and even surgery to continuously improve the physical effects of CP.

In January, Natalie underwent a surgery to lengthen her hamstrings and loosen the tension and spasticity in her leg muscles in hope of increasing her ability to walk.  Once her casts were removed, Natalie was admitted to RIC as an inpatient for rehabilitation to strengthen her muscles, and improve her balance and endurance with the goal of getting her back on her feet.

Natalie has been participating in Lokomat therapy three times a week to help retrain her step patterns and build her strength, coordination and endurance. It is believed that Lokomat therapy, in combination with her the surgical intervention and ongoing care, will improve her ability to walk.

“As a parent, I want Natalie to work to her full potential,” said Christine Davis, Natalie’s mother. “The walker had become quite a challenge, so we hope that the Lokomat will help improve her walking.  So far, we have seen an improvement in her leg strength, and her endurance has gotten better.”
Candidates for Robot-Assisted Walking Therapy on the Lokomat

Children with neurological conditions who are about four years old or older (or who have a femur length of at least 21 cm) and who are evaluated by a physician to determine if they are medically appropriate for robot-assisted walking therapy are eligible. If you are interested in having your child evaluated for Lokomat therapy, please call 1-312-238-6100 or make an appointment online for an evaluation with Dr. Deborah Gaebler-Spira or Dr. Gadi Revivo.

About The Rehabilitation Institute of Chicago
The Rehabilitation Institute of Chicago (RIC) is making a difference in the world for people with disabilities.  RIC provides world-class care to patients from around the globe for a range of conditions from acute brain and spinal cord injury to chronic arthritis, pain and sports injuries.  RIC, founded in 1954, has been designated the “#1 Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991 and attributes its leading standard of care in part to its innovative research and discovery, particularly in the areas of bionic medicine, robotics, neural regeneration, pain care and better outcomes. RIC operates its 165-bed, Flagship hospital in downtown Chicago , as well as a network of 30 sites of care located throughout the city and surrounding suburbs that provide additional inpatient care, day rehabilitation and outpatient services. RIC also maintains strategic alliances with leading healthcare providers throughout the state of Illinois and Indiana.

[1] U.S. News & World Report has ranked RIC the “#1 Rehabilitation Hospital ” every year since 1991.

[2] Centers for Diseases Control (CDC), 2008 data

[3] The Rehabilitation Centre for Children and Young People (Affoltern am Albis , Switzerland ); Dr. von Haunerschen Kinderspital (Munich ) and Hocoma, 2007

Robotics Trends would like to thank the Rehabilitation Institute of Chicago for permission to reprint this article.  The original article can be found at http://www.ric.org/aboutus/mediacenter/press/2009/0210.aspx.


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